State faults Ontario County’s home-health services

Thursday

The state Health Department said Ontario County nurses failed to update patients’ records or explain the side effects of drugs. The errors had the potential to cause problems, but no one was injured.

A report by the state Department of Health found Ontario County’s Home Health Agency needs to improve record-keeping and do a better job following up on doctors’ orders on procedures and medications.

The state’s on-site review of the agency’s activities took place over six days, from Sept. 26 to Oct. 3, and involved pulling “a cross-section of records” for a “random look,” said Jeffrey Hammond, department spokesman.

Hammond said the review was routine and not prompted by a complaint. It involved interviewing staff, making seven home visits and reviewing 19 clinical records, including five belonging to long-term-care patients.

Among the findings:

• For four patients, staff had not updated clinical records to note doctors’ orders pertaining to treatment.

• For four patients, staff had not alerted doctors to changes in their condition that could have altered their plan of care.

• For five patients, staff did not identify and discuss potential side effects of medications with them.

These 13 instances involved 9 patients.

Hammond said none of the deficiencies, including “bad” record-keeping, harmed patients. “It didn’t lead to a problem, but it could have,” he said.

Hammond said the agency must produce a plan of correction and will be reviewed again by the department to make sure the standards are met.

Jody Gray, the county’s director of public health, said the agency takes the report “very seriously.”

“We have developed a plan of action to go out this week” to meet a deadline of 10 days to present the department with a plan, she said. “We’ll put out a plan of action and do some staff retraining,” she added.

Ontario County’s Home Health Care Agency provides care to about 150 county residents in their homes. Some of the caregivers are county employees; others are employed by private contractors.

About 50 patients get specialized care such as physical therapy. Most patients, about 100, get home care following surgery or a hospital stay, or, in some cases, for ongoing medical conditions. Those patients are largely cared for by nurses and home-health aides. Aides help with chores such as bathing and dressing.

The Health Department report faulted only procedures performed by nurses.
“There were no issues related to home-health aides,” Gray said.

contracting with Rochester-based Lifetime Care Home Health Agency for its home-health aides.

The county’s home-health aide services have been on the radar since the county Board of Supervisors decided Nov. 16, 2006 to eliminate the county’s 12 full-time home-health aides and their two part-time supervisors, effective last July. Those county employees, covered under union contract, made about one-third of the county’s health aide visits. The rest of the visits were done by aides from a private company.

Cost estimates showed the county would save about $500,000 annually over the next five years by eliminating the county jobs and instead contracting with a private service for all health aide visits. The county currently contracts with Rochester-based Lifetime Care Home Health Agency for its home-health aides.

The change continues to draw criticism from those who say they aren’t getting the same level of care from the private agencies as the county workers provided.

“We lost Ontario County (aides) bit by bit,” said Farmington resident Barbara Bode, whose daughter, Kerry Bode, receives home care for cerebral palsy. Barbara said it took a while to find a private-agency aide who did a good job. While they eventually found aides they liked, she said, those aides aren’t available as often as the county aides had been.

“It’s not the same,” said Barbara.

Meanwhile, Gray and Supervisor Donald Jensen, R-Seneca, the chairman of the county’s Health and Medical Services Committee, say they are generally pleased with the way the transition has gone. Jensen said he heard complaints initially about the county eliminating its aides, but he thinks the agency is handling its responsibilities well.

Gray said the home-health agency routinely surveys patients to rate the quality of care they are receiving. With 5 the highest rating, Gray said the home-health agency currently has a rating of 4.9.

Julie Sherwood can be reached at (585) 394-0770, Ext. 263, or at jsherwood@mpnewspapers.com.